Objective To analyze and evaluate the early warning efficacy of D-dimer/albumin ratio(DAR)combined with interleukin-6(IL-6)and fibrin degradation products(FDP)in the postoperative treatment of acute Stanford type A aortic dissection(ATAAD).Methods A retrospective cohort study was conducted on 284 ATAAD patients who underwent the Sun's procedure at our hospital from July 2024 to March 2025.Patients were divided into a non-adverse outcome group(n=196)and an adverse outcome group(n=88)based on the occurrence of postop-erative complications within 30 days,including acute renal failure requiring dialysis,secondary thoracotomy for hemostasis,severe neurological complications,multiple organ failure,or all-cause mortality.Preoperative baseline data,perioperative parameters,and laboratory indicators were collected via the electronic medical record system.The Mann-Whitney U test was used to compare the differences between groups for continuous variables that did not conform to the normal distribution,and Chi-square test or Fisher's exact test was selected for statistical difference analysis according to the frequency distribution characteristics of categorical variables.On the basis of univariate analysis,multivariate logistic regression analysis was used to screen independent risk factors.Results Statistically significant differences were observed between the non-adverse and adverse outcome group in age,cardiopulmonary bypass time,lactate dehydrogenase(LDH),IL-6,D-dimer(D-D),FDP,and DAR levels(P<0.05).Multivariate analysis revealed that DAR,IL-6,D-D,FDP,and prolonged cardiopulmonary bypass time were independent risk factors for adverse postoperative outcomes(P<0.05).Combined detection analysis demonstrated that the combination of DAR,IL-6,FDP,and cardiopulmonary bypass time yielded the highest predictive efficacy,with an area under the ROC curve of 0.886(95％CI:0.846～0.927).Conclusion The combination of DAR,IL-6,FDP,and cardio-pulmonary bypass time effectively predicts adverse postoperative outcomes in ATAAD patients.This biomarker panel may serve as a robust predictive tool for postoperative risk stratification.

Objective To analyze and evaluate the early warning efficacy of D-dimer/albumin ratio(DAR)combined with interleukin-6(IL-6)and fibrin degradation products(FDP)in the postoperative treatment of acute Stanford type A aortic dissection(ATAAD).Methods A retrospective cohort study was conducted on 284 ATAAD patients who underwent the Sun's procedure at our hospital from July 2024 to March 2025.Patients were divided into a non-adverse outcome group(n=196)and an adverse outcome group(n=88)based on the occurrence of postop-erative complications within 30 days,including acute renal failure requiring dialysis,secondary thoracotomy for hemostasis,severe neurological complications,multiple organ failure,or all-cause mortality.Preoperative baseline data,perioperative parameters,and laboratory indicators were collected via the electronic medical record system.The Mann-Whitney U test was used to compare the differences between groups for continuous variables that did not conform to the normal distribution,and Chi-square test or Fisher's exact test was selected for statistical difference analysis according to the frequency distribution characteristics of categorical variables.On the basis of univariate analysis,multivariate logistic regression analysis was used to screen independent risk factors.Results Statistically significant differences were observed between the non-adverse and adverse outcome group in age,cardiopulmonary bypass time,lactate dehydrogenase(LDH),IL-6,D-dimer(D-D),FDP,and DAR levels(P<0.05).Multivariate analysis revealed that DAR,IL-6,D-D,FDP,and prolonged cardiopulmonary bypass time were independent risk factors for adverse postoperative outcomes(P<0.05).Combined detection analysis demonstrated that the combination of DAR,IL-6,FDP,and cardiopulmonary bypass time yielded the highest predictive efficacy,with an area under the ROC curve of 0.886(95％CI:0.846～0.927).Conclusion The combination of DAR,IL-6,FDP,and cardio-pulmonary bypass time effectively predicts adverse postoperative outcomes in ATAAD patients.This biomarker panel may serve as a robust predictive tool for postoperative risk stratification.

To report the first case of chronic disseminated paracoccidioidomycosis in China. A 49-year-old male patient presented with papules and nodules of the skin for 1 year, and papules and ulcers on the oral mucosa for 2 months. Skin examination showed the edema of the left foot, multiple crusting ulcers on the sole of the left foot, ulcers with a granular base in the interdigital regions between the third and fourth toes as well as fourth and fifth toes of the left foot, accompanied by punctate hemorrhage and exudation; there were multiple papules, nodules, and plaques on the dorsum and medial side of the left foot and the left knee, with ulcers and crusts in the center; 2 papules were observed on the left wrist, and 1 papule on the left upper lip with a crusted surface; red plaques with ulcers and punctate hemorrhage were observed on the gingival mucosa, buccal mucosa, labial mucosa, and palate, and the lesions mainly occurred on the left side. Ultrasonography of superficial lymph nodes showed bilateral cervical and supraclavicular lymph node enlargement, which was more obvious on the left side. Computed tomography of the chest and abdomen showed diffuse miliary nodular shadows, and cordlike, cloudy flocculent and nodular high-density shadows in both lungs, as well as obvious thickening of the left adrenal gland in the abdomen. Yeast cells were observed by immunofluorescent staining of biopsy tissues from the oral mucosa and left lower limb. Histopathological examination of biopsy tissues from the oral mucosa and left lower limb showed granulomatous inflammation, and refractive double-membrane yeast cells could be observed inside or outside the multinucleated giant cells, without or with a single bud or multiple buds; periodic acid-Schiff staining and hexamine silver staining of the above biopsy tissues were positive. Fungal culture of the left lower limb lesion in Sabouraud dextrose agar medium at 25℃ and 37℃ both yielded fungal hyphae. Metagenomics sequencing of the oral mucosal tissue and alveolar lavage fluid indicated the infection with Paracoccidioides brasiliensis. The diagnosis of chronic disseminated paracoccidioidomycosis was confirmed. After 1-month oral treatment with itraconazole capsules at a dose of 400 mg/d, the lesions on the skin and oral mucosa markedly improved, and computed tomography imaging of the lung and left adrenal gland also showed obvious improvement. The dose of itraconazole was reduced to 200 mg/d after 3 months. The patient′s condition further improved during a 10-month follow-up.

【Objective】 To investigate the feasibility of differentiation of human AB plasma hematopoietic stem/progenitor cells (HSCs/HPCs) from peripheral blood into mature erythrocytes. 【Methods】 Hematopoietic stem/progenitor cells were induced to be differentiated into mature erythrocytes in the medium supplemented with 5% FBS, 3% FBS + 2% human AB plasma and 8% human AB plasma, respectively, and inoculated in 24-well culture plate at the density of 1×10⁶/mL. Cell proliferation and morphological changes were observed in three different groups. Flow cytometry was used to detect erythroid terminal differentiation markers, i. e. GPA, Band3 and α4(α4-integrin), and late erythroid cell enucleation in different group. The effects of different culture conditions on HSCs/HPCs differentiation into mature erythrocytes were compared. 【Results】 The cell growth and proliferation multiples of the three groups (8% human AB plasma, 5% FBS and 3% FBS+ 2% human AB plasma) were 2 573±116 vs 2 514±246 vs 2 539±119(P>0.05), respectively. The morphological changes of the three groups were similar. With the extension of culture time, the cells differentiated from proerythroblasts to basophils, polychromatic erythroblasts and positive erythroblasts, and almost all of them differentiated into erythrocytes enucleation on day 21. GPA expression and enucleation rate(%) of the three groups were 97.17±1.91 vs 94.95±1.61 vs 96.15±1.38, and 85.1±3.26 vs 86.93±5.96 vs 86.5±3.36(P>0.05), respectively. 【Conclusion】 The differentiation of HSCs/HPCs from peripheral blood plasma into mature erythrocytes from human AB was similar to that of fetal bovine serum.

Objective:To analyze the genomic epidemiological subtyping of carbapenem resistant Klebsiella pneumoniae (CRKP) isolated from a Third-class A hospital in Zhengzhou. Methods:From December 4, 2019 to January 10, 2020, 67 strains of CRKP were isolated from the samples submitted by the clinical departments of a Third-class A teaching hospital in Zhengzhou for microbiological testing. Multi-locus sequence typing (MLST) and carbapenem resistance genes were identified by whole genome sequencing and sequence analysis. Based on the whole genome SNP, the phylogenetic tree was constructed, and 67 CRKP strains were divided into clonal groups. The isolation ward and date of each clone group were analyzed.Results:Sixty-seven CRKP strains were classified into four MLST types (STs), of which 64 were ST11. There were 62 ST11 strains carrying blaKPC-2 gene. Based on genome-wide SNP phylogenetic tree, 64 ST11 strains were divided into four clone groups, two of which were dominant clone groups, including 33 and 27 strains respectively; the other two clone groups only contained 2 strains respectively. There was no aggregation of the dominant clones in the isolation department and date. Conclusion:Multiple clonal groups of ST11 strain carrying blaKPC-2 gene are differentiated during spreading, and they can spread in parallel and independently in the same hospital.

Objective:To analyze the genomic epidemiological subtyping of carbapenem resistant Klebsiella pneumoniae (CRKP) isolated from a Third-class A hospital in Zhengzhou. Methods:From December 4, 2019 to January 10, 2020, 67 strains of CRKP were isolated from the samples submitted by the clinical departments of a Third-class A teaching hospital in Zhengzhou for microbiological testing. Multi-locus sequence typing (MLST) and carbapenem resistance genes were identified by whole genome sequencing and sequence analysis. Based on the whole genome SNP, the phylogenetic tree was constructed, and 67 CRKP strains were divided into clonal groups. The isolation ward and date of each clone group were analyzed.Results:Sixty-seven CRKP strains were classified into four MLST types (STs), of which 64 were ST11. There were 62 ST11 strains carrying blaKPC-2 gene. Based on genome-wide SNP phylogenetic tree, 64 ST11 strains were divided into four clone groups, two of which were dominant clone groups, including 33 and 27 strains respectively; the other two clone groups only contained 2 strains respectively. There was no aggregation of the dominant clones in the isolation department and date. Conclusion:Multiple clonal groups of ST11 strain carrying blaKPC-2 gene are differentiated during spreading, and they can spread in parallel and independently in the same hospital.

Objective:To investigate the epidemiological and molecular biological characteristics of heterogeneous vancomycin-intermediate Staphylococcus aureus (hVISA) in blood culture. Methods:hVISA was detected using Mueller-Hinton agar containing 5 μg/ml of teicoplanin (MHA5T) and Populats profiles/area under the curve (PAP/AUC). Staphylococcal cassette chromosome mec ( SCCmec), Staphylococcus aureus protein A ( spa) and accessory gene regulator ( agr) typing and multilocus-sequence typing (MLST) were analyzed using PCR. Difference in autolysis between hVISA and vancomycin-sensitive Staphylococcus aureus (VSSA) isolates were evaluated with Triton X-100-inducd autolysis. Expression of vraR, mgrA, icaA, icaR, pbp4 and agr genes in hVISA and VSSA strains were detected by real-time PCR. Results:The positive detection rate of methicillin-resistant Staphylococcus aureus (MRSA) in blood culture was 39.5% (136/344) in our hospital. Among the MRSA strains, there were 31 strains of hVISA (22.8%). The minimum inhibitory concentrations (MIC) of vancomycin were mainly 1.5 μg/ml (54.8%) and 2 μg/ml(25.8%)against hVISA isolates, and 0.5 μg/ml (46.7%) and 0.75 μg/ml (39.0%) against VSSA isolates. The predominant clone of hVISA was ST239- SCCmecⅢ-t030- agrⅠ accounting for 71.0% (22/31). The autolysis of hVISA isolates decreased significantly as compared with that of VSSA isolates ( χ2=13.583, P=0.032). Compared with VSSA strains, the expression of vraR, mgrA and icaA genes in hVISA strains increased by 1.58, 1.53 and 1.06 times ( P<0.01), while the expression of icaR, agr and pbp4 genes decreased by 0.85, 0.61 and 1.03 times ( P<0.05). Conclusions:The prevalence rate of hVISA in our hospital reached 22.8% and the main epidemic clone was ST239- SCCmecⅢ-t030- agrⅠ, which should be paid great attention to clinically. Rational use of antibiotics, strengthening the prevention and control of nosocomial infection, and avoiding the spread of hVISA strains and the emergence of VISA and VRSA (vancomycin-resistance Staphylococcus aureus) were also necessary.

Objective:To investigate the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) between donor and recipient. Methods:Pregnancy outcomes of 31 donors of infertility patients of ovarian hyperresponsiveness and 30 recipients receiving by IVF-ET from January 2011 to December 2016 in the Reproductive Center of Henan Provincial People's Hospital were retrospectively analyzed.Results:The implantation rate of frozen-thawed embryo transfer (FET) cycle (52.05% vs. 58.70%), the clinical pregnancy rate (69.23% vs.73.91%), the live birth rate per transplant cycle (61.54% vs.65.22%), the cumulative pregnancy rate per oocyte pick-up cycle (87.10% vs. 100.00%), the twin rate (40.74% vs. 48.39%), and the live birth rate (77.42% vs. 96.77%) were slightly higher in donor group than in recipient group, while there were no significant differences ( P>0.05). There were no significant differences in implantation rate (58.70% vs. 40.74%), clinical pregnancy rate (76.00% vs. 57.14%), early abortion rate (5.26% vs. 12.50%) and live birth rate per transplant cycle (72.00% vs. 42.86%) between group of <38 years old and group of ≥38 years old ( P>0.05). There were significant differences in cumulative pregnancy rate (100.00% vs. 66.67%) and live birth rate per oocyte pick-up cycle (94.74% vs. 50.00%) ( P=0.037, P=0.007). Conclusion:Oocyte donation IVF-ET is an effective method to assist infertility patients such as premature ovarian failure, perimenopausal period, chromosomal abnormalities, and repeated failure of IVF-ET. The success rate of pregnancy in the recipients of oocyte is similar to that in the donors. All different age groups of recipients can obtain good pregnancy outcomes, and the young recipients have a higher live birth rate.

Objective:To investigate the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET) between donor and recipient. Methods:Pregnancy outcomes of 31 donors of infertility patients of ovarian hyperresponsiveness and 30 recipients receiving by IVF-ET from January 2011 to December 2016 in the Reproductive Center of Henan Provincial People's Hospital were retrospectively analyzed.Results:The implantation rate of frozen-thawed embryo transfer (FET) cycle (52.05% vs. 58.70%), the clinical pregnancy rate (69.23% vs.73.91%), the live birth rate per transplant cycle (61.54% vs.65.22%), the cumulative pregnancy rate per oocyte pick-up cycle (87.10% vs. 100.00%), the twin rate (40.74% vs. 48.39%), and the live birth rate (77.42% vs. 96.77%) were slightly higher in donor group than in recipient group, while there were no significant differences ( P>0.05). There were no significant differences in implantation rate (58.70% vs. 40.74%), clinical pregnancy rate (76.00% vs. 57.14%), early abortion rate (5.26% vs. 12.50%) and live birth rate per transplant cycle (72.00% vs. 42.86%) between group of <38 years old and group of ≥38 years old ( P>0.05). There were significant differences in cumulative pregnancy rate (100.00% vs. 66.67%) and live birth rate per oocyte pick-up cycle (94.74% vs. 50.00%) ( P=0.037, P=0.007). Conclusion:Oocyte donation IVF-ET is an effective method to assist infertility patients such as premature ovarian failure, perimenopausal period, chromosomal abnormalities, and repeated failure of IVF-ET. The success rate of pregnancy in the recipients of oocyte is similar to that in the donors. All different age groups of recipients can obtain good pregnancy outcomes, and the young recipients have a higher live birth rate.

Objective To study the expression of tumor necrosis factor -α (TNF-a) and correlation with TNF-a in breast cancer. Methods We used SABC method to detect the expression of TNF-a in 112 cases of primary breast cancer, and analysis the relationship between TNF-α with histologic grades and ER. Results The positive expression rate of TNF-α in breast cancer was higher than those of normal tissues and lobular hyperplasia of the breast (X2 =8.573, P =0.014). There was no significant correlation between histologic grades and TNF-α (X2 =1.304, P =0.521). TNF-a had a positive correlation with ER in breast cancer (X2=11.949, P =0.001). Conclusion The positive expression rate of TNF-α in breast cancer was higher than those of normal tissues and lobular hyperplasia of the breast.TNF-α had a positive correlation with ER in breast cancer, but the exact mechanism is unclear.